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Preventative healthcare

William L Hasler, Laura A Wilson, Linda A Nguyen, William J Snape, Thomas L Abell, Kenneth L Koch, Richard W McCallum, Pankaj J Pasricha, Irene Sarosiek, Gianrico Farrugia, Madhusudan Grover, Linda A Lee, Laura Miriel, James Tonascia, Frank A Hamilton, Henry P Parkman
BACKGROUND & AIMS: Many patients with gastroparesis are prescribed opioids for pain control, but indications for opioid prescription and relations of opioid use to gastroparesis manifestations are undefined. We characterized associations of use of potent vs weaker opioids and presentations of diabetic and idiopathic gastroparesis. METHODS: We collected data on symptoms, gastric emptying, quality of life, and healthcare resource use from 583 patients with gastroparesis (more than 10% 4 hr scintigraphic retention) from the NIDDK Gastroparesis Consortium, from January 2007 through November 2016...
October 13, 2018: Clinical Gastroenterology and Hepatology
Satoshi Ogihara, Takashi Yamazaki, Hirohiko Inanami, Hiroyuki Oka, Toru Maruyama, Kota Miyoshi, Yuichi Takano, Hirotaka Chikuda, Seiichi Azuma, Naohiro Kawamura, Kiyofumi Yamakawa, Nobuhiro Hara, Yasushi Oshima, Jiro Morii, Rentaro Okazaki, Yujiro Takeshita, Sakae Tanaka, Kazuo Saita
Surgical site infection (SSI) is a significant complication after spinal surgery and is associated with increased hospital length of stay, high healthcare costs, and poor patient outcomes. Accurate identification of risk factors is essential to develop strategies to prevent wound infections. The aim of this prospective multicenter study was to determine the independent factors associated with SSI in posterior lumbar surgeries without fusion (laminectomy and/or herniotomy) for degenerative diseases in adult patients...
2018: PloS One
Yanbin Zhu, Song Liu, Wei Chen, Bo Liu, Hongzhi Lv, Xiaolin Zhang, Yingze Zhang
OBJECTIVE: The aim of the study was to report the incidence of low-energy fracture since menopause in postmenopausal women ≤70 years and to explore associated risk factors METHODS:: This was a part of the Chinese National Fracture Survey (CNFS), which was carried out in eight provinces of China mainland between January and May 2015. Data on 68,783 postmenopausal women ≤70 years were extracted from the CNFS database for calculations and analyses. RESULTS: A total of 309 women were confirmed to have low-energy fractures in 2014, indicating the incidence of 449...
October 15, 2018: Menopause: the Journal of the North American Menopause Society
Isabel A Morgan, Cheryl L Robbins, Kathleen C Basile
Exposure to violence can harm women's overall health and well-being. Data suggest that one in three women in the United States experience some form of violence by an intimate partner in their lifetime. In this commentary, we describe the implications of intimate partner violence (IPV) on women's health, specifically for women of reproductive age. We use a life-course perspective to describe the compounded impact of IPV on preconception health. Preconception health generally refers to the overall health and well-being of women (and men) before pregnancy...
October 2018: Journal of Women's Health
Amanda S Parsons, Varna Raman, Bronwyn Starr, Mark Zezza, Colin D Rehm
OBJECTIVES: To examine if Medicare reimbursements for the Diabetes Prevention Program (DPP) cover program costs. STUDY DESIGN: A retrospective modeling study. METHODS: A microcosting approach was used to calculate the costs of delivering DPP in 2016 to more than 300 patients from Montefiore Health System (MHS), a large healthcare system headquartered in Bronx, New York. Attendance and weight loss outcomes were used to estimate Medicare reimbursement...
October 2018: American Journal of Managed Care
Arthur Vrignaud, Simon Pelletier, Emmanuelle Dernis, Yvon Moui, Bénédicte Haettich
Osteoporosis is responsible for fragility fractures, thus causing significant morbidity and mortality. This study shows that care pathways, such as Le Mans General Hospital Fracture Liaison Service, are useful and efficient in improving the prevention of osteoporosis and of its consequences. INTRODUCTION: Osteoporosis is a major public health concern, causing significant morbidity and mortality. Care pathways, called Fracture Liaison Services, have demonstrated their utility in preventing osteoporosis-associated morbidity and mortality...
October 15, 2018: Archives of Osteoporosis
Mehrdad Gholami, Alireza Salimi Chirani, Reza Falak, Mona Moshiri, Shabnam Razavi, Gholamreza Irajian
Background: Pseudomonas aeruginosa , an opportunistic pathogen, is a common cause of healthcare-associated infections in immunocompromised individuals. The rapid emergence of multidrug-resistant strains has made P. aeruginosa infections progressively difficult to treat. In this study we evaluated the effect of a chimeric protein containing a P. aeruginosa PilQ fragment and the PilA disulfide loop (PilA-DSL) on the humoral immune response in BALB/c mice. Methods: A chimeric gene encoding an immunogenic region of PilQ and the PilA-DSL was synthesized...
October 2018: Reports of Biochemistry & Molecular Biology
Crystal S Denlinger, Tara Sanft, K Scott Baker, Gregory Broderick, Wendy Demark-Wahnefried, Debra L Friedman, Mindy Goldman, Melissa Hudson, Nazanin Khakpour, Allison King, Divya Koura, Robin M Lally, Terry S Langbaum, Allison L McDonough, Michelle Melisko, Jose G Montoya, Kathi Mooney, Javid J Moslehi, Tracey O'Connor, Linda Overholser, Electra D Paskett, Jeffrey Peppercorn, William Pirl, M Alma Rodriguez, Kathryn J Ruddy, Paula Silverman, Sophia Smith, Karen L Syrjala, Amye Tevaarwerk, Susan G Urba, Mark T Wakabayashi, Phyllis Zee, Nicole R McMillian, Deborah A Freedman-Cass
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for common physical and psychosocial consequences of cancer and cancer treatment to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period. This portion of the guidelines describes recommendations regarding the management of anthracycline-induced cardiotoxicity and lymphedema. In addition, recommendations regarding immunizations and the prevention of infections in cancer survivors are included...
October 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Nitika Pant Pai, Jana Daher, H R Prashanth, Achal Shetty, Rani Diana Sahni, Rajesh Kannangai, Priya Abraham, Rita Isaac
OBJECTIVES: In rural pregnant Indian women, multiple missed antenatal screening opportunities due to inadequate public health facility-based screening result in undiagnosed HIV and sexually transmitted bloodborne infections (STBBIs) and conditions (anaemia). Untreated infections complicate pregnancy management, precipitate adverse outcomes and risk mother-to-child transmission. Additionally, a shortage of trained doctors, rural women's preference for home delivery and health illiteracy affect health service delivery...
October 15, 2018: Sexually Transmitted Infections
Monika Pogorzelska-Maziarz, Pamela B de Cordova, Carolyn T A Herzig, Andrew Dick, Julie Reagan, Patricia W Stone
BACKGROUND: Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. We evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. METHODS: A web-based survey of a national sample of all non-veteran hospitals enrolled in the National Healthcare Safety Network was conducted in fall 2011. Variations in IPC department resources and characteristics in states with and without laws were compared by use of χ², Mann-Whitney (Wilcoxon), and Student t tests...
October 12, 2018: American Journal of Infection Control
Swati Agarwal, Faisal A Alzahrani, Asif Ahmed
BACKGROUND: Throughout history, menopause has been regarded as a transition in a woman's life. With the increase in life expectancy, women now spend more than a third of their lives in menopause. During these years, women may experience intolerable symptoms both physically and mentally, leading them to seek clinical advice. It is imperative for healthcare providers to improve the quality of life by reducing bothersome menopausal symptoms and preventing disorders such as osteoporosis and atherosclerosis...
October 14, 2018: International Journal of Molecular Sciences
Marisa Miraldo, Carol Propper, Rachael I Williams
In 2006, the Massachusetts healthcare reform was introduced to mandate health insurance, extend eligibility of publicly subsidised health insurance, improve quality and access to care and develop preventive health services. The objective of this study was to determine the impact of expanding publicly subsidised health insurance through the Massachusetts reform on access to primary care, disease management and behavioural risk factors. Using cross-sectional data from the Behavioural Risk Factor Surveillance System (BRFSS) from 2001 to 2010 and exploiting the selective introduction of the healthcare reform, we assessed its impact on primary care access, behavioural risk factors, such as obesity, and receipt of diabetes management tests...
September 20, 2018: Social Science & Medicine
Margreet S H Wortman, Joran Lokkerbol, Johannes C van der Wouden, Bart Visser, Henriëtte E van der Horst, Tim C Olde Hartman
BACKGROUND: In primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients and society with high healthcare costs and societal costs. Objectives were to provide an overview of the evidence regarding the cost-effectiveness of interventions for MUS or FSS, and to assess the quality of these studies. METHODS: We searched the databases PubMed, PsycINFO, the National Health Service Economic Evaluation Database (NHS-EED) and the CEA registry to conduct a systematic review...
2018: PloS One
David Taylor, Ruth McCaffrey, Humberto Reinoso, Mary W Mathis, Lisa Dickerson, Johnathan Hamrick, Suzie L Madden, Henry H Heard, Ellen Perlow, Christine M Klein
An aging population benefits from healthcare providers trained in the care of older adults. Interprofessional education (IPE) and service-learning activities focused on geriatric conditions like falls may address this need. A fall prevention IPE activity using the Centers for Disease Control and Prevention (Stopping Elderly Accidents, Deaths & Injuries (STEADI) initiative was implemented to prepare health sciences students to manage older adult falls. Students (N = 31) and faculty (N = 10) from five health sciences programs and local older adults (N = 27) participated...
October 15, 2018: Gerontology & Geriatrics Education
Lisa Moses, Monica J Malowney, Jon Wesley Boyd
BACKGROUND: Concerns about ethical conflicts, moral distress, and burnout in veterinary practice are steadily increasing. Root causes of these problems have not been rigorously identified. Little research has been done to evaluate the existence of moral distress in North American veterinarians or to explore its impact on career sustainability and poor well-being. HYPOTHESIS/OBJECTIVES: Ethical conflict and resultant moral distress are common occurrences in contemporary veterinary practice and negatively impact daily practice life, but may not be identified or labeled by veterinarians as such...
October 15, 2018: Journal of Veterinary Internal Medicine
Hannah L Nathan, Nicola Vousden, Elodie Lawley, Annemarie de Greeff, Natasha L Hezelgrave, Nicola Sloan, Nina Tanna, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Jane Sandall, Lucy C Chappell, Andrew H Shennan
Objectives: Haemorrhage, hypertension, sepsis and abortion complications (often from haemorrhage or sepsis) contribute to 60% of all maternal deaths. Each is associated with vital signs (blood pressure (BP) and pulse) abnormalities, and the majority of deaths are preventable through simple and timely intervention. This paper presents the development and evaluation of the CRADLE Vital Signs Alert (VSA), an accurate, low-cost and easy-to-use device measuring BP and pulse with an integrated traffic light early warning system...
October 2018: BMJ Innovations
Brian R Wood, Maren S Mann, Natalia Martinez-Paz, Kenton T Unruh, Mary Annese, David H Spach, John D Scott, Joanne D Stekler
Background: Pre-exposure prophylaxis (PrEP) is an effective tool to prevent HIV infection for at-risk individuals, but access requires medical providers to be aware of and comfortable with prescribing PrEP. Project ECHO (Extension for Community Healthcare Outcomes) was started to support hepatitis C virus treatment in rural New Mexico, but has since expanded to train health practitioners to treat other medical conditions in other locations. Methods: In 2012, a Project ECHO telehealth program was launched to mentor community HIV practitioners in our region...
October 15, 2018: Sexual Health
Marian E Betz, Christopher E Knoepke, Bonnie Siry, Ashley Clement, Deborah Azrael, Stephanie Ernestus, Daniel D Matock
OBJECTIVES: We sought to (1) clarify decision needs among suicidal adults with home firearm access; (2) identify accurate, unbiased and acceptable approaches for content and messaging; and (3) develop a tablet-delivered decision aid for firearm storage options. METHODS: Following international standards, we used stakeholder interviews to develop a decision aid for the decision, 'what option(s) to choose to reduce home access to firearms for an adult at risk of suicide'...
October 13, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
L G Mercuri
Prosthetic joint infections are not only distressing complications for patients and surgeons, but also have an enormous financial impact on healthcare systems. The reported incidence of prosthetic joint infection is likely underestimated due to difficulties in their diagnosis. This unfortunate complication has challenged joint replacement surgeons for years, despite all the advances made in this surgical discipline. Since eradication of these infections can be very difficult, prevention remains the primary objective...
October 10, 2018: International Journal of Oral and Maxillofacial Surgery
James M Perrin, Joan Rosenbaum Asarnow, Terry Stancin, Stephen P Melek, Gregory K Fritz
OBJECTIVE: To estimate additional payments associated with co-existing mental health or substance use disorders (MH/SUD) among commercially-insured children and youth with chronic medical conditions (CMC). To determine whether children's MH/SUD have similar associations with parental health care payments. METHOD: Cross-sectional analysis of a national database of paid commercial insurance claims for 2012-13. Participants were children/youth ages 0-26 years covered as dependents on parents' health insurance and categorized by presence or absence of any of 11 chronic medical conditions and MH/SUD...
October 10, 2018: Academic Pediatrics
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